ScholarLink (思领科)
错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of sterile gloving during proximal manipulation of central line catheter hub: the multicenter observational study CleanHandPROX

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年10月6日

查看全文
  • Sandra Dos Santos,
  • Anne-Sophie Valentin,
  • Mathilde Farizon,
  • Nathalie van der Mee-Marquet,
  • Alexandra Allaire,
  • Sophie Allemon-Dewulf,
  • Amina Azzam,
  • Frédéric Barbut,
  • Magali Bauer,
  • Virginie Bayon,
  • Laetitia Bernadou,
  • Bénédicte Bogard,
  • Sundy Bordelais,
  • Laetitia Borrelys,
  • Cécile Bourgain,
  • Céline Chatelet,
  • Lydia Decruyenaere,
  • Peggy Delavault,
  • Claudia Douat-Beyries,
  • Julie Douay,
  • Marlène Ducasse-Mege,
  • Fatia El-Boundri,
  • Elisabeth Fino,
  • Clotilde Groleau,
  • Christelle Guillard,
  • Danielle Jaafar,
  • Emmanuelle Joseph,
  • Gratienne Laethem,
  • Adeline Ledez,
  • Florence Malfondet,
  • Nadine Mertel,
  • Nadine Negrin,
  • Anne Perez,
  • Aline Prenant,
  • Morgane Valsaque,
  • Marie-Christine Gadras

摘要

Background

Patients with central lines face an increased risk of developing bacteremia. Preventing late-onset catheter-related infections relies on implementing various measures during manipulations of the catheter hub of central lines (e.g., during connections, disconnections, blood withdrawals, pulsed rinses, or injections performed at the first connection after the central catheter). French guidelines include, among these measures, the requirement to put on sterile gloves immediately before proximal manipulation to help prevent contamination of the catheter hub during preparation. To our knowledge, no study has reported compliance with wearing sterile gloves during these manipulations, nor the impact of not wearing sterile gloves on the cleanliness of the fingers of healthcare workers (HCWs) just before manipulating the connectors.

Methods

We conducted a two-part study to assess compliance with sterile gloving and to provide direct microbiological evidence of bacterial contamination on HCWs’ hands immediately before the manipulation of central lines when sterile gloving is not used. First, the use of sterile gloves was observed during proximal manipulations of central lines using a standardized grid. Second, we examined the microbial flora present on the fingers of each observed HCW just before proximal manipulation.

Results

A total of 260 HCWs from 35 healthcare institutions were observed during proximal manipulation. The HCWs were distributed into three groups: 188 used sterile gloves (72%), 23 used nonsterile gloves (9%), and 49 did not wear gloves (19%). The swabbing of the fingertips revealed microbial cultures from 72 samples (28%). A total of 97 microorganisms were identified, all of which are well-recognized agents responsible for catheter-related bacteremia, predominantly coagulase-negative staphylococci (n = 36) and Bacillus sp. (n = 31). Fingertip contamination was lower for HCWs wearing sterile gloves (27/188; 14%) than for those wearing nonsterile gloves (12/23; 52%) or not wearing gloves (33/49; 67%) (p < 0.001). The contaminants were similar across the three groups.

Conclusions

Our data support the positive impact of sterile gloving in ensuring clean fingertips during proximal manipulation of central lines, a key measure in preventing late-onset catheter-related bacteremia. The contamination of sterile gloves in one out of seven HCWs highlights the need for a clean care environment and minimal contact with the patient’s skin and surroundings during proximal manipulation.